Treatment Resistance in Anxiety Disorder: Generalized Anxiety Disorder and Social Anxiety Disorder

2018 ◽  
pp. 207-214
Author(s):  
Kang Soo Lee ◽  
Sang Hyuk Lee
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Generalized Anxiety Disorder ◽  
Social Anxiety Disorder ◽  
Treatment Resistance ◽  
Generalized Anxiety

Social Anxiety Disorder (Social Phobia)

2009 ◽  
Author(s):  
Vladan Starcevic, MD, PhD
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Phobia ◽  
Generalized Anxiety Disorder ◽  
Social Anxiety Disorder ◽  
Generalized Anxiety ◽  
Making Sense ◽  
The Status ◽  
Bona Fide ◽  
Severe Psychopathology

Social anxiety disorder (SAD) is conceptualized as an excessive and/or unreasonable fear of situations in which the person’s behavior or appearance might be scrutinized and evaluated. This fear is a consequence of the person’s expectation to be judged negatively, which might lead to embarrassment or humiliation. Typical examples of feared and usually avoided social situations are giving a talk in public, performing other tasks in front of others, and interacting with people in general. Although the existence of SAD as a psychopathological entity has been known for at least 100 years, it was only relatively recently, with the publication of DSM-III in 1980, that SAD (or social phobia) acquired the status of an ‘‘official’’ psychiatric diagnosis. The term social anxiety disorder has been increasingly used instead of social phobia, because it is felt that the use of the former term conveys more strongly the pervasiveness and impairment associated with the condition and that this term will promote better recognition of the disorder and contribute to better differentiation from specific phobia (Liebowitz et al., 2000). Like generalized anxiety disorder, social anxiety disorder is common and controversial. Unlike generalized anxiety disorder, which is described in different ways by different diagnostic criteria and different researchers and clinicians, SAD does not suffer from a ‘‘description problem.’’ It is not particularly difficult to recognize features of SAD; what may be difficult is making sense of these features. Main issues associated with SAD are listed below…. 1. Where are the boundaries of SAD? How well is SAD distinguished from ‘‘normal’’ social anxiety and shyness on one hand, and from severe psychopathology on the other? 2. Is there a danger of ‘‘pathologizing’’ intense social anxiety by labeling it a psychiatric disorder? How can the distress and suffering of people with high levels of social anxiety be acknowledged if they are not given the corresponding diagnostic label? 3. Is SAD a bona fide mental disorder? 4. Can the subtyping scheme (nongeneralized vs. generalized SAD) be supported? 5. Is there a spectrum of social anxiety disorders?

Pharmacological Treatments for Panic Disorder, Generalized Anxiety Disorder, Specific Phobia, and Social Anxiety Disorder

2015 ◽  
Author(s):  
Ryan J. Kimmel ◽  
Peter P. Roy-Byrne ◽  
Deborah S. Cowley
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Panic Disorder ◽  
Generalized Anxiety Disorder ◽  
Social Anxiety Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Specific Phobia ◽  
Generalized Anxiety ◽  
Pharmacological Treatments ◽  
First Line

Selective serotonin reuptake inhibitors (SSRIs) are the first-line pharmacological treatment for panic disorder based on their low rate of side effects, lack of dietary restrictions, and absence of tolerance. SSRIs and venlafaxine are attractive first-line treatments for social anxiety disorder. Pharmacological treatments of choice for generalized anxiety disorder are buspirone and antidepressants, including SSRIs and venlafaxine. Benzodiazepines, although effective for all these disorders, lack efficacy for comorbid depression and carry the risk of physiological dependence and withdrawal symptoms. Their greatest utility seems to be as an initial or adjunctive medication for patients with disabling symptoms requiring rapid relief and for those unable to tolerate other medications. Chronic treatment with benzodiazepines is generally safe and effective but should probably be reserved for patients nonresponsive or intolerant to other agents. Larger trials are necessary to determine whether pharmacological agents might be useful as monotherapies, or adjuncts to exposure psychotherapy, for specific phobia.

scholarly journals Smartphone-Detected Ambient Speech and Self-Reported Measures of Anxiety and Depression: Exploratory Observational Study (Preprint)

2020 ◽  
Author(s):  
Daniel Di Matteo ◽  
Wendy Wang ◽  
Kathryn Fotinos ◽  
Sachinthya Lokuge ◽  
Julia Yu ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Observational Study ◽  
Generalized Anxiety Disorder ◽  
Social Anxiety Disorder ◽  
Strong Relationship ◽  
Self Report ◽  
Generalized Anxiety ◽  
Depression And Anxiety ◽  
Severity Of Depression

BACKGROUND The ability to objectively measure the severity of depression and anxiety disorders in a passive manner could have a profound impact on the way in which these disorders are diagnosed, assessed, and treated. Existing studies have demonstrated links between both depression and anxiety and the linguistic properties of words that people use to communicate. Smartphones offer the ability to passively and continuously detect spoken words to monitor and analyze the linguistic properties of speech produced by the speaker and other sources of ambient speech in their environment. The linguistic properties of automatically detected and recognized speech may be used to build objective severity measures of depression and anxiety. OBJECTIVE The aim of this study was to determine if the linguistic properties of words passively detected from environmental audio recorded using a participant’s smartphone can be used to find correlates of symptom severity of social anxiety disorder, generalized anxiety disorder, depression, and general impairment. METHODS An Android app was designed to collect periodic audiorecordings of participants’ environments and to detect English words using automatic speech recognition. Participants were recruited into a 2-week observational study. The app was installed on the participants’ personal smartphones to record and analyze audio. The participants also completed self-report severity measures of social anxiety disorder, generalized anxiety disorder, depression, and functional impairment. Words detected from audiorecordings were categorized, and correlations were measured between words counts in each category and the 4 self-report measures to determine if any categories could serve as correlates of social anxiety disorder, generalized anxiety disorder, depression, or general impairment. RESULTS The participants were 112 adults who resided in Canada from a nonclinical population; 86 participants yielded sufficient data for analysis. Correlations between word counts in 67 word categories and each of the 4 self-report measures revealed a strong relationship between the usage rates of death-related words and depressive symptoms (<i>r</i>=0.41, <i>P</i>&lt;.001). There were also interesting correlations between rates of word usage in the categories of reward-related words with depression (<i>r</i>=–0.22, <i>P</i>=.04) and generalized anxiety (<i>r</i>=–0.29, <i>P</i>=.007), and vision-related words with social anxiety (<i>r</i>=0.31, <i>P</i>=.003). CONCLUSIONS In this study, words automatically recognized from environmental audio were shown to contain a number of potential associations with severity of depression and anxiety. This work suggests that sparsely sampled audio could provide relevant insight into individuals’ mental health. CLINICALTRIAL

scholarly journals A diary study of feedback seeking behaviours in individuals with social anxiety disorder compared to individuals with generalized anxiety disorder of no history of mental health difficulties

2021 ◽  
Author(s):  
Gillian Wilson
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Generalized Anxiety Disorder ◽  
Social Anxiety Disorder ◽  
Positive Feedback ◽  
Common Source ◽  
Generalized Anxiety ◽  
Healthy Individuals ◽  
Feedback Seeking ◽  
Significant Group

The current study examined various features of positive feedback seeking (PFS) and negative feedback seeking (NFS) in individuals with social anxiety disorder (SAD), individuals with generalized anxiety disorder (GAD), and healthy individuals using a 2-week daily diary method. There were no significant differences between individuals with SAD and healthy individuals in the frequency of feedback seeking. However, individuals with GAD engaged in significantly more overall feedback seeking (adjusted for compliance) than healthy individuals. The most common source of feedback seeking within each group was other people (e.g., romantic partner). Individuals with SAD experienced significantly greater reductions in anxiety, sadness, and anger than healthy individuals and a significantly greater increase in certainty than individuals with GAD following positive feedback during PFS. There were no significant group differences in the topics, triggers, functions, or termination criteria of feedback seeking. Future research directions and theoretical and clinical implications of these findings are discussed.

scholarly journals A diary study of feedback seeking behaviours in individuals with social anxiety disorder compared to individuals with generalized anxiety disorder of no history of mental health difficulties

2021 ◽  
Author(s):  
Gillian Wilson
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Generalized Anxiety Disorder ◽  
Social Anxiety Disorder ◽  
Positive Feedback ◽  
Common Source ◽  
Generalized Anxiety ◽  
Healthy Individuals ◽  
Feedback Seeking ◽  
Significant Group

The current study examined various features of positive feedback seeking (PFS) and negative feedback seeking (NFS) in individuals with social anxiety disorder (SAD), individuals with generalized anxiety disorder (GAD), and healthy individuals using a 2-week daily diary method. There were no significant differences between individuals with SAD and healthy individuals in the frequency of feedback seeking. However, individuals with GAD engaged in significantly more overall feedback seeking (adjusted for compliance) than healthy individuals. The most common source of feedback seeking within each group was other people (e.g., romantic partner). Individuals with SAD experienced significantly greater reductions in anxiety, sadness, and anger than healthy individuals and a significantly greater increase in certainty than individuals with GAD following positive feedback during PFS. There were no significant group differences in the topics, triggers, functions, or termination criteria of feedback seeking. Future research directions and theoretical and clinical implications of these findings are discussed.

scholarly journals The Relationship Between Smartphone-Recorded Environmental Audio and Symptomatology of Anxiety and Depression: Exploratory Study (Preprint)

2020 ◽  
Author(s):  
Daniel Di Matteo ◽  
Kathryn Fotinos ◽  
Sachinthya Lokuge ◽  
Julia Yu ◽  
Tia Sternat ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Generalized Anxiety Disorder ◽  
Social Anxiety Disorder ◽  
Functional Impairment ◽  
Self Report ◽  
Anxiety And Depression ◽  
Generalized Anxiety ◽  
Severity Of Depression ◽  
Insight Into

BACKGROUND <i>Objective</i> and <i>continuous</i> severity measures of anxiety and depression are highly valuable and would have many applications in psychiatry and psychology. A collective source of data for objective measures are the sensors in a person’s smartphone, and a particularly rich source is the microphone that can be used to sample the audio environment. This may give broad insight into activity, sleep, and social interaction, which may be associated with quality of life and severity of anxiety and depression. OBJECTIVE This study aimed to explore the properties of passively recorded environmental audio from a subject’s smartphone to find potential correlates of symptom severity of social anxiety disorder, generalized anxiety disorder, depression, and general impairment. METHODS An Android app was designed, together with a centralized server system, to collect periodic measurements of the volume of sounds in the environment and to detect the presence or absence of English-speaking voices. Subjects were recruited into a 2-week observational study during which the app was run on their personal smartphone to collect audio data. Subjects also completed self-report severity measures of social anxiety disorder, generalized anxiety disorder, depression, and functional impairment. Participants were 112 Canadian adults from a nonclinical population. High-level features were extracted from the environmental audio of 84 participants with sufficient data, and correlations were measured between the 4 audio features and the 4 self-report measures. RESULTS The regularity in daily patterns of activity and inactivity inferred from the environmental audio volume was correlated with the severity of depression (<i>r</i>=−0.37; <i>P</i>&lt;.001). A measure of sleep disturbance inferred from the environmental audio volume was also correlated with the severity of depression (<i>r</i>=0.23; <i>P</i>=.03). A proxy measure of social interaction based on the detection of speaking voices in the environmental audio was correlated with depression (<i>r</i>=−0.37; <i>P</i>&lt;.001) and functional impairment (<i>r</i>=−0.29; <i>P</i>=.01). None of the 4 environmental audio-based features tested showed significant correlations with the measures of generalized anxiety or social anxiety. CONCLUSIONS In this study group, the environmental audio was shown to contain signals that were associated with the severity of depression and functional impairment. Associations with the severity of social anxiety disorder and generalized anxiety disorder were much weaker in comparison and not statistically significant at the 5% significance level. This work also confirmed previous work showing that the presence of voices is associated with depression. Furthermore, this study suggests that sparsely sampled audio volume could provide potentially relevant insight into subjects’ mental health.

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